Toothache after a filling - Is this normal?

introduction

Anyone who has ever suffered from toothache knows this more than unpleasant feeling. An appointment with the dentist should be a way out of the pain.

This removes the tooth decay and fills the tooth. All right, right? Unfortunately not.

Toothache can be caused by many different things. Only a dentist can tell what exactly is the cause of the toothache. In most cases, a carious lesion ( commonly known as caries ) is responsible.
Carious lesions can spread very far until they finally make themselves felt. Then the damage is usually very big and a little harder to fix. Regular check-ups at the dentist, which should be done once a year, help to detect tooth decay at an early stage and to prevent more damage to the tooth.
The tooth is made up of the outer enamel layer that surrounds the dentin core. Inside the dentin, the pulp is completely protected. Among other things, the pulp contains the nerve of the tooth. From here, nerve fibers are sent into the dentin and transmitted pain stimuli. The nutrition of the tooth is also ensured by the pulp. Blood vessels and various cell types ensure that the tooth gets everything it needs to function well in the mouth.
Toothache is perceived by the nerve within a tooth. If it comes to irritation of the nerve, you perceive this as a pain. Toothache in the first days after a filling is relatively common.

Depending on the way you fill your teeth, toothache is more likely or unlikely. The larger and deeper the extent of the caries, the closer it gets to the tooth nerve.
Caries removal and especially preparation with dental drills may cause mechanical irritation in the form of vibration or heat. During filling, acid is used during the preparation of the enamel ( melt conditioning ).

Here a chemical irritation of the nerve is possible. Even the most commonly used plastic filling itself can be the cause of the toothache. The applied plastic consists of monomers, these are connected by means of UV light and thus cured. Monomers left over may irritate the tooth nerve, triggering pain. Too high a filling can be the cause in question, since it can lead to overloading of the tooth.

The toothache must be differentiated after a filling of a nerve inflammation ( Pulpitis / Zahnmarkentzündung). The former is temporary and the tooth still has a feeling of cold, although the nerve inflammation is irreversible and the tooth here has no sense of cold and is thus dead. Pulpitis requires root canal treatment.

Toothache after a filling usually manifests as hypersensitivity, so pain especially when biting or in:

  • sweet
  • sour
  • hot
  • cold

be perceived. The pain itself is rather bright and pungent and may initially be permanent.

Therapeutically, after a tooth filling, you can cool the affected jaw section or, in the case of severe toothache, take painkillers (eg ibuprofen 400 mg).

It should be noted that toothache occurs after filling after the anesthesia dies down, as it represents an intermediate hypersensitivity of the dental nerve and that after a few days an improvement should occur. In the case of a permanent or throbbing pain, which often leads to waking up from sleep, another visit to the dentist is recommended to rule out pulpitis (tooth root inflammation).

In summary, the deeper the caries is, and thus the closer the nerve is, the more likely subsequent pain is . However, they are only of a temporary nature.

Pictures toothache after a filling

Figure toothache after filling

Toothache after filling
(by biting, sweet, sour,
hot or cold)

  1. Dental Caries (Carious Lesion) -
    Caries dentium
  2. Access to the dental pulp
    will be exposed
    (Precise high-tech instruments)
  3. Cleaning with antibacterial solution
    (Special rinsing solutions or gels)
  4. Root canal comes with a
    special filling material tight
    locked
  5. Tooth with a filling or
    Sealing the crown (ceramic,
    Plastics, metal alloys,
    Amalgam)
    What helps against complaints:
    A - Prudent cooling
    (maximum half an hour)
    B - Chamomile or peppermint tea
    C - tea tree oil
    (not too often, do not swallow)
    D - analgesics (analgesics) -
    Ibuprofen, paracetamol, aspirin
    E - mouth rinses with clove extract

causes

Often, no pain is felt directly after the visit to the dentist, the patient leaves the practice satisfied. Only with decreasing numbness do pain become noticeable.

For these reasons, the tooth may be sensitive after filling:

  • The removal of the caries, so the softened and infected substance is done by means of drills, which must be performed with a slight pressure. In this case, the pulp, so colloquially the tooth nerve, can be irritated.
  • In order to create the adhesive bond between tooth and filling, an etching gel is applied, which can also irritate the pulp.
  • The dental filling material itself can be irritating in rare cases.
  • If the filling is too high, the tooth becomes overloaded and hurts.
  • The soft tissue can also be easily injured by the filling therapy, but it recovers quickly.

How long does the pain last?

In most cases, a filling due to a carious defect is necessary. Some patients continue to complain of mild toothache even after successful restorative therapy over a period of time. Basically, after a filling, these toothaches are caused by irritations in the oral mucous membranes, the gums or the smallest nerve fibers.

Depending on which of these structures is affected after filling, the duration of the toothache also differs. If a filling due to caries is necessary, the depth of the carious defect has a decisive influence on the duration of toothache.

However, in general, affected patients may expect that toothache after filling should not exceed two to three days. If the symptoms persist even after the filling has been completed, the treating dentist should urgently be consulted again.

Pressure pain after a tooth filling

In addition to temporary toothache, a feeling of pressure is one of the most commonly described phenomena that occurs after a filling is applied. Similar to the persisting toothache, the pressure perceived by the patient can be attributed to irritation of the oral mucous membranes, gums or nerve fibers, which can also be triggered by the new filling material.
This pressure should disappear completely after just a few days. If a patient observes a pressure that lasts longer than three days after filling has been completed, this could be a first indication of the development of inflammatory processes. The treating dentist should therefore be visited again for the purpose of clarification.

Throbbing pain after a tooth filling

Toothache, depending on its cause, comes in many forms. They range from a bright, pointed to a pulling, burning to a dull and / or pulsatile throbbing pain, which is accompanied by a disturbing feeling of pressure and not infrequently with a swelling.

Most patients complain that the pain in the evening is worse than in the morning and especially when lying down. This can be caused by a dead tooth nerve. Then a root canal treatment must be performed, after which the pressure feeling can continue for up to three days. Painkillers can help, but it is usually not necessary to use an antibiotic.

Other reasons for a throbbing pain may be existing wisdom teeth, as these ignite easily. Removal of the teeth is then strongly advised. But also a so-called periodontal disease, a bacterial inflammation of the periodontium, can cause the unpleasant pain, especially if it has been accidentally missed in a filling therapy. In both cases, an antibiotic must be clarified with the attending physician.

What helps against the toothache?

Patients who continue to experience toothache even after successful filling often wonder what is helping them. In the first days after applying the filling, toothache is of little concern. Concerned patients can quickly get relief by careful cooling. In this context, care should be taken, however, that the coolant is never applied directly to the skin. Ideally, a small cooling pad should be wrapped in a kitchen towel and placed on the cheek. However, since the cooling of the aching tooth should only take place over a short period of time (about half an hour), further tips can be used to help against toothache after a filling.

Home remedies for toothache are very popular.
Many patients use chamomile or peppermint tea to relieve toothache even after a filling. Also, chewing on dried rosemary leaves should be something that helps with toothache after a filling. Above all, rosemary leaves are suitable for exerting a soothing effect on irritations in the area of ​​the tooth nerve.
Tea tree oil can also be used, but only with the utmost care. It is best to soak a cotton swab in the oil, and then dab off the aching tooth and surrounding gums. Do not do it too often and make sure that no oil is swallowed!
Mouthwashes with clove extract have an analgesic effect. A carnation that works just as well in the mouth and is then brought to the painful place.

If the pain persists, the dentist must be visited again. It may well be that the filling is a bit too high and therefore the tooth remains very sensitive.
The dentist bites the patient for occlusal foil (a colored paper that marks the points on the surface of the tooth that will be bitten during biting) and thus controls the height of the filling again. If the fillings are too high, they will be ground in and the pain should disappear within a day.
If there is a suspicion that the tooth is reacting to the filling material and causing the pain, the filling must be replaced. However, this is never the case with modern composite materials.

If after a very deep caries with subsequent filling the patient develops dull, throbbing pains that are so bad that he wakes up even at night, a root canal treatment must be initiated more often. The pulp became so irritated and irritated by drilling that it can no longer calm down alone and therefore causes pain that can only be removed by removing the pulp.
Analgesics ( pain medication ) such as ibuprofen, paracetamol or aspirin can relieve the pain. Your intake should be limited in time to avoid liver damage or the like. These painkillers are available over the counter at any pharmacy.
When aspirin is to be noted that it has anticoagulant effect. If another visit to the dentist or another procedure is planned, you should stop taking aspirin the day before.

She might also be interested in this : toothache after drilling

homeopathy

Toothache should always be treated by a dentist!
Toothache after a filling can also be relieved well over a short period of time with the help of some substances from the field of homeopathy.
The most commonly used homeopathic remedies for toothache are Arnica, onion juice, Belladonna and Rhododendron.
Another proven homeopathic remedy is a acupressure point that can be squeezed for fillings after a toothache. He is in the dimple between the nose and upper lip and should be pressed firmly for one to two minutes.
However, the patient should be aware that the use of homeopathic remedies can never replace a timely visit to the dentist, especially if the pain lasts longer or becomes too great.

How long are toothaches after a filling normal?

Toothache after filling is extremely common and normal in itself. How severe the pain is depends on how deep the carious destruction has progressed. The tooth is very sensitive after the dental procedure, so care should be taken not to eat too hard, sweet, sour or extremely hot or cold food to give the tooth the opportunity to regenerate. In the first hours after the treatment the pain can be constant.

This hypersensitivity may last for about three to seven days to several weeks. The important thing is that the pain does not get worse. However, if they last longer or feel rather dull or throbbing, then another visit to the dentist is unavoidable, as it could be an overlooked so-called root inflammation ( periodontitis ). Prolonged irritation of the tooth can lead to its death, so it is always important to observe the course of pain and the duration of the pain and to have it clarified if necessary.

Toothache when chewing after a filling

If a tooth is filled, it can be painful, especially when eating and drinking. These have different causes.

For one thing, it may be because the filling is too high and therefore bothers you when biting. On the tooth, therefore, there is too much stress. The dentist probably did not grind the filling enough. Another option is that the artificial tooth crown is too low so that the denture does not fit properly. Even the slightest bumps or changes in familiar situations cause the muscles to cramp or the temporomandibular joint is not in the right position.

Even the opposite tooth can begin to hurt over time due to the high pressure. Therefore, it is always important to pay attention to the correct height of the teeth. However, it can be difficult to judge if something is bothering during an existing anesthetic. If necessary, the treating dentist must shorten or increase the filling subsequently after the anesthesia has subsided.

Another reason for pain when chewing is a schleiftrauma of the tooth by its removal of material with the drill. Even if the filling therapy is already completed, it can after some time to painful reactions, especially when chewing hard food, come. In addition, the toothache can be caused by the fact that the filling is leaking at its edges and thus accumulate the smallest components of the food in it. Depending on how long this condition lasts or the longer the filling already exists, it can come to a so-called secondary, that is, subsequent, caries, which destroys the teeth under the filling. This then causes the typical unpleasant drawing caries pain.

However, if the pain already occurs immediately after the filling has been laid, in particular an amalgam filling, these may also be aggravated when consuming very hot or very cold food, which is due to the fact that amalgam as metal relieves cold and heat in the body Near the sensitive pulp leads. Even very sweet or sour drinks, such as sodas or juices, can penetrate into microscopic channels in the tooth, triggering the pain.

Toothache from nerve irritation

The oral cavity, including the teeth, is generally a space densely packed with small branches of the fifth cranial nerve. The nerve fibers penetrate through small holes in the jaw from below into the tooth root and then lie within the tooth, which is why he is very sensitive to the smallest external influences.

If a tooth has been damaged by a tooth decay, it must be removed or a dental root canal followed by a filling therapy. In particular, the files, instruments, drills, rinsing solutions and other equipment required can lead to mechanical, chemical and thermal irritation of the tooth nerve. Especially with a plastic filling it comes to the use of an acid that irritates the tooth in addition. The cavities may have penetrated so deeply that they even irritated the nerve.

Both are then felt as pain. In most cases, such an operation is performed under a local anesthetic of the nerve, which is why the toothache is perceived at home only after the anesthesia has subsided.

Nocturnal toothache after filling

Many patients who complain of persistent toothache after filling, report an intensification of the symptoms during the night. In some cases, the toothache even occurs entirely after the completion of a filling only at night.
In fact, this perception of the affected patients is not based on pure imagination but can be explained scientifically. In this context, one has to be aware that toothache is usually in a close causal relationship to inflammatory processes within the oral cavity. Various inflammatory mediators are able to bind to pain receptors and thus mediate pain perception. The release of these inflammatory mediators in turn is promoted by a strong circulation.

As the circulation within the oral cavity increases at night due to the lying position, toothache after a filling during sleep is felt to be stronger. For the same reason, the toothache can only be noticed at night. Another explanation for the occurrence of toothache after a filling that only manifests itself at night is the fact that inflammatory processes are to a certain extent temperature-dependent. If the patient lies on the aching cheek for a longer period at night, it will overheat within the tissue. As a result, the release of inflammatory mediators is increased and the patient only experiences toothache at night.

Toothache and earache after a filling

Ear and headache after a filling therapy are not uncommon. Due to the long open holding of the mouth or due to high fillings, there is often a tension in the masticatory muscles, which also radiates into the temporomandibular joint and is perceived as an earache.

These structures are anatomically close to the ear, more precisely in the vicinity of the so-called Tuba auditiva, a tubular connection between the oral cavity and the middle ear. If an injection of the anesthetic injection causes a bruise or, in the worst case, even an abscess due to delayed germs, the auditory tuba is narrowed. Earache is the result. Also, a strong irritation of the lower jaw, especially in treatments in the molar region of both jaws, which supplies both the masticatory muscles and the tensioner of the eardrum, can trigger pain in the backward nerve course. These can be treated easily, after consultation with the treating dentist, with painkillers.

Is it normal to have toothache after a filling? II Partha Dental II (December 2019).


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